| Objective:to evaluate the effects of peripheral blood stem cells transplantation(PBSCT) to myocardial and circulative reconstruction by comparing two groups of patients' cardiac function after operation.Patients in group A were received the operation of coronary artery bypass grafting(CABG) and autologous peripheral blood stem cells transplantation(APBSCT) simultaneously while group B were received the operation of CABG.Methods:From September 2007 to October 2008,a total of 32 cases(including 23 male and 9 female) of patients with coronary heart disease companied by myocardial infarction in my hospital for surgical treatment were chosen,of which the age were ranged from 52y to 73y.All the patients have 2 or 3 branch of coronary arterial pathological changes and the stenosis rate differed from 75%to 100%.There were 1 to 3 months long from last myocardial infarction happening.These cases were randomly divided into two groups.Patients of group A were received the treatment of operation of CABG and APBSCT simultaneously while group B were received the operation of CABG.In order to acquire the PBSCs,patients in group A were mobilized by injecting granulocyte colony-stimulating factor(G-CSF) into hypoderm five days before the operation.Hemacyte extractor was used to collect the PBSCs when mobilizationb finished one day before the operation.In the operation,the PBSCs were transplanted to the infarcted area by injecting them through the bridge bypass and the extrocardium near infracted area.The following parameters were recorded after operation,such as the ratio of arrhythmia and the low cardiac output syndrome(LCOS),the inotropic drug support requirement,the length of stay-in the intensive care unit.Get the blood sample and examine the concentration and changes of CK-MB and cTnI at the time respectively in 2h,6h,12h,24h,48h and 72h after operation.In order to understand the cardiac function,left ventricle ejection fraction(LVEF) and other related index were checked with equipment of Doppler ultrasound at the time respectively in 1 week, 1month,3month and 6month after operation.1 week before and 6month after the operation, scanning of technetium 99m methoxy iso butyl isonitile(99mTc-MIBI) was respectively checked to understand the blood reflow.Results:3 cases in group A and 4 cases in group B suffered arrhythmia after operation. LOSC happened on 1 patient in each group.The inotropic drug(Dopamine) use dose was less and the length of stay in intensive care unit(ICU) was shorter in group A.Concentration of CK-MB and cTnI increased somehow after the operation in both groups,but there was not statistical divergence(P＞0.05);The result of color Doppler echocardiography 1 week after operation showed that the index of LVEF,LVEDD in both group had no improvement than pre-operation,and there was no statistical divergence between 2 groups(P＞0.05);The LVEF,LVEDD 1 month after the operation showed that both groups improved than pre-operation,and group A was better than group B.Both the index of 3 and 6 month after the operation indicated that the LVEF,LVEDD improved than pre-operation dramatically,of which group A was better than group B and there was statistical divergence between 2 groups(P＜0.05);Examination of 99mTc-MIBI showed the infracted area(filling defect area) decreased in both groups 6 month after the operation and new filling in group A improved more dramatically than that of group B.Conclusion:Autologous peripheral blood stem cells transplantation can improve myocardium reconstruction and blood recircularization in infarction area so as to improve cardiac function. |
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